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1993, 05-21 Permit App 93003806 Mechanical FixturesL(5(S3.6640 corms-�� I� �[ _JECHA ICAL 'ERiVilT APPLICK }N FORM ( � 1 l �(- GC��� I� !((9 `rC Information Worksheet JOB STREET ADDRESS: 790 % �6` . �(� % CITY/STATE/ZIP: 9 �7 ,J.� PARCEL NUMBER: (� PHONE NUMBER: S7 ( - G9 / 6/ OWNER: ALllr MAILING ADDRESS: 93- 7 cz-7 (Street) CONTRACTOR: i<%-,(ec n iQF' (City/State) (Zip) LICENSE NUMBER: 1 CO C(4A / 732 PHONE NUMBER: (-C (7E7 MAILING ADDRESS: F : .� 03 I TL J /�� 1 DESCRIPTION (Street) (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) T....V. :WQQIaSTO l.~liNS�R�' ......... :.: GAS WATER HEATER GAS: EQ.U!PMENT nipoO:ETq(1UCLU GAS EQUIPMENT +100,000 BTU DUCTWORK) GAS:>AtPl.l'iG:,.I1T• ::?<>«<<:>:>::<:<:><>::<>::«:>€<:<:<::<: BOILER/REFRIG 1-100M BTU BOII�I�RIREFP.I� �0TU:.:• BOILER/REFRIG 501-1,000M BTU BOILER/REFRIG +1,750M BTU HEATi001 P & AIP CONDITIO NER 0 3 TO•• SS HEAT PUMP & AIR CONDITIONER 3-15 TONS H EAT:PUM':.&. AIR: CONDITION ER: 1 5-30 TONS: HEAT PUMP & AIR CONDITIONER 30-50 TONS :HEAT PUMP & AIR CONDITIONER +50 TONS..... VENTILATING FANS TYPE 1 H000 (PER 12' OR 12' PTN. OF HOOD) :•: 1:::•.: !':.:r.::4�::�: \ v w w i::vi: :;•i:v:iii:Ji::i:^:iJ:ii3ii: Y::vii: i:•: : i:vi::•: ^i:'::^:Si:'•; i':: ii: }:.:::: i:;: CLOTHES DRYER RANG...: <:: ::>::::.;;:.:::.>:.•::;:::;::; GAS LOG MISCELLANEOUS.(NOTCOVERED ELSEWHE E' UNLISTED GAS APPLIANCE <400:000 BTU UL!NS�ED GAS APPLlANCE.>404 000 STU..:......'; USED APPLIANCE <400,000 BTU USED APPLIANCE:>400,000 BTU; AIR HANDLER <10,000 CFM • !AlR I ANDLER > .0,000 CFAA NOTE: MINIMUM PERMIT FEE IS $35.00 (Zip) NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 = x 25.00 = x 10.00 = x12.00= x 15.00 = x 1.00 = x 12.00 = x 20.00 = x 25.00 = x 35.00 = x 60.00 = x 12.00 = x 20.00 = x 25.00 = x35.00 = x60.00 = x 10.00 = x 10.00 = x 50.00 = x 10.00 = x 10.00 = x 10.00 = x 10.00 = x 1,0.00 = x 5ca0 = x100.00 = x 50.00 = x100.00 = x 12.00 = x 15.00 = A (P) i t • SUBTOTAL $ / ?, a PLUS: PROCESSING FEE + $ / 25.00 EQUALS: TOTAL PERMIT FEE DUE =$ a-c SIGNATURES-� Spokane County Division of Buildings West 1 '<`3 Broadway Avenue SpOkane,, WA 99260 (509) 456-3675